基于断层图像人体骨骼有限元几何模型的快速重建-第三军医大学学报.doc

三维虚拟穿刺仿真在颈部深静脉穿刺置管术中的应用 曹加明, 傅栋2 (1解放军98医院中心ICU,浙江湖州 313000; 2武警8691部队医院, 浙江湖州 313003;) 【摘要】目的:寻求三维虚拟穿刺仿真技术在颈部深静脉穿刺置管术中的应用。方法:取健康志愿者颈部连续CTA动脉造影断面图像，Mimics软件对骨骼、肌肉、动静脉、甲状腺、喉软骨等组织进行半自动分割和重建，三维化显示颈部深静脉及周围相关解剖结构,并进行颈部深静脉穿刺虚拟仿真,包括模拟颈内静脉, 锁骨上静脉和锁骨下静脉穿刺。结果: 成功模拟颈内静脉、锁骨上静脉和锁骨下静脉穿刺，显示虚拟穿刺针和骨性结构、动静脉、肌肉等解剖结构的三维毗邻关系,并测量穿刺进针的安全角度、深度、最佳穿刺路径。结论: 三维虚拟穿刺仿真技术可以为颈部深静脉穿刺术提供直观的形态学参考。 【关键词】三维；虚拟仿真；深静脉；穿刺术 Application of three-dimensional virtual punctuation simulation to cervical deep vein punctuation Cao Jiaming1, Fu Dong2 1Department of Anesthesiology，98th Hospital of PLA,Huzhou 313000, Zhejiang province ，China; 28691 Hospital of armed police，Huzhou 313003，Zhejiang province ,China； 【Abstract】Objective: To find application of three-dimensional virtual punctuation simulation to cervical deep vein punctuation. Methods: Basing on continuous CT angiography 2-Dimensional cross section pictures from the cervical part of one healthy volunteer, half-auto cut and reconstruction are taken to skeleton、muscles、artery、veins、thyroid gland、laryngeal cartilages etc.by the Mimics software according to the different threshold of tissue .Three-dimensional model of cervical deep veins and its surrounding relational local anatomic structure are successfully displayed and cervical deep veins punctuation are virtual emulated, including simulation of internal jugular vein、upclavian vein and subclavian vein puncture. Results: Internal jugular vein、upclavian vein and subclavian vein puncture are successfully simulated, three-dimensions adjoin relation of the virtual pin with skeleton 、carotid arteries、jugular veins、muscles etc.are successfully displayed，and pin`s safe angle、depth or optimization path are measured. Conclusion: A three-dimensional virtual punctuation simulation can provide visualized morphologic data for cervical deep vein punctuation. 【Key words】Three-dimension；virtual simulation；deep vein ;punctuation 颈部深静脉置管在危重病人抢救中发挥重要的作用，通过深静脉管可以采取快速输液、中心静脉测压、血流动力学监测、深静脉营养等重要治疗手段。但颈部深静脉在穿刺置管过程中可能出现出血、神经损伤